Organization Active NPI

Nephrology Associates SC

  • Specialist
  • Waukesha, WI
National Provider Identifier
1871679514
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NEPHROLOGY ASSOCIATES SC
Practice address
1260 Sentry Dr Ste 140
Waukesha, WI 53186-5990
Phone
(262) 524-1024
Fax
(262) 524-8767
NPI assigned
Oct 27, 2006
Last updated
Dec 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jennifer L Christman
Title
Administrator
Phone
(262) 524-1024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X WI Primary

Addresses

Primary practice location

1260 Sentry Dr Ste 140
Waukesha, WI 53186-5990

Mailing address

1260 Sentry Dr Ste 140
Waukesha, WI 53186-5990
Phone (262) 524-1024

Other identifiers 1

IdentifierTypeStateIssuer
32807900MedicaidWI

Other names 1

  • Nephrology Associates of Waukesha, SC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000115 WI Part B Supplier - Clinic/Group Practice 7416841663 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Watertown, WI; Waukesha, WI; Sussex, IL; New Berlin, WI; Muwonago, WI; Germantown, WI; Fort Atkinson, WI; Brookfield, WI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0896397Nephrology Associates, SC1260 Sentry Drive, Ste 140, Waukesha, WI 53186Provider-performed microscopyJan 8, 2027

National Provider Directory

National Provider Directory

Locations

2085 N Calhoun Rd
Ste 201
Brookfield, WI 53005
Phone 26278299856

1256 Corporate Ctr Dr
Oconomowoc, WI 53066
Phone (262) 567-3199

1260 Sentry Dr
Ste 140
Waukesha, WI 53186
Phone 2625241024300

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1871679514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 SENTRY DR STE 140",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865990",
            "telephone_number": "262-524-1024",
            "fax_number": "262-524-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 SENTRY DR STE 140",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865990",
            "telephone_number": "262-524-1024",
            "fax_number": "262-524-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "CHRISTMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "262-524-1024",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32807900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nephrology Associates of Waukesha, SC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Nephrology Associates of Waukesha, SC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.